Tendon, ligament, and joint capsular injuries represent 45% of the almost 33 million musculoskeletal injuries each year in the United States, and hand injuries account for 5-10% of annual emergency department visits nationwide (Praemer et al., 1999). Common among these injuries are flexor tendon lacerations, concomitant with injury to adjacent structures, as well as ruptures, especially in individuals active in sports (Leddy, 1988). Successful repair of ruptured flexor tendons, as measured by return of gliding function, is a great challenge to hand surgeons because of the nature of tendon repair, which often results in indiscriminate adherence of the tendon to surrounding tissue (Schneider & Hunter, 1988).
The surgeon's objective in repair is to create an environment in which the injured tendon can heal with a minimal amount of fibrosis and tissue reaction, and then following an initial protection period, to undergo controlled physical therapy regimens to mobilize the repaired tendon, and ensure restoration of the gliding function, while minimizing the risk of re-injury (Leddy, 1988; Schneider & Hunter, 1988).